Order ID:89JHGSJE83839 | Style:APA/MLA/Harvard/Chicago | Pages:5-10 |
Instructions:
Variations Between Specific Programs in Different Populations
How does effectiveness vary between specific programs in different populations (e.g., by race,
SES, educational attainment, age, cognitive or physical disabilities)?
How effective are programs delivered through the internet, email, apps, or social networking?
What is the relative effectiveness of individual and group sessions?
What structures and systems are needed to maintain program effectiveness and help participants?
continue their improvements to diet and physical activity following program completion?
What are long-term effects on participants’ glycemic control, weight loss, cardiovascular disease
risk factors, morbidity, and mortality?
What are program attrition rates? Why do participants drop out, and how can they be retained?
Are these interventions effective with children and adolescents?
All included studies were randomized controlled trials.
Evaluated interventions provided a median of 11 sessions that were individual (3 studies) or a
combination of individual and group sessions (4 studies).
Studies evaluated interventions that provided patients specific, tailored instruction on lifestyle
changes through multiple interactions over extended periods of time.
Four of the programs provided additional, extended telephone contact and 2 of the programs had
frequent, ongoing contact with patients through regular exercise sessions.
The median intervention duration was 12 months. All 7 studies established clear goals for
patients’ dietary changes (3 studies), physical activity levels (5 studies), or weight loss (2 studies).
https://www.thecommunityguide.org/about/evidence-gaps
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Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2
diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016;27;37- 47.
Included Studies
The number of studies and publications do not always correspond (e.g., a publication may include several studies
or one study may be explained in several publications).
Effectiveness Review
Studies from Huang et al. (2016) Included in this Review
Ali M, Schifano F, Robinson P, Phillips G, Doherty L, Melnick P, et al. Impact of community pharmacy
diabetes monitoring and education programme on diabetes management: a randomized controlled
study. Diabet Med 2012;29(9):e326–33.
Balducci S, Zanuso S, Nicolucci A, De Feo P, Cavallo S, Cardelli P, et al. Effect of an intensive exercise
intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes
mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med 2010;170:1794–803.
Chan CW, Siu SC, Wong CK, Lee VW. A pharmacist care program: positive impact on cardiac risk in
patients with type 2 diabetes. J Cardiovasc Pharmacol Ther 2012;17:57–64.
Coppell KJ, KataokaM, Williams SM, Chisholm AW, Vorgers SM, Mann JI. Nutritional intervention in
patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment—Lifestyle
Over and Above Drugs in Diabetes (LOADD) study: randomised controlled trial. BMJ 2010;341:c3337.
Crasto W, Jarvis J, Khunti K, Skinner TC, Gray LJ, Brela J, et al. Multifactorial intervention in individuals
with type 2 diabetes and microalbuminuria: the Microalbuminuria Education and Medication
Optimisation (MEMO) study. Diabetes Res Clin Pract 2011;93: 328–36.
Dobrosielski DA, Gibbs BB, Ouyang P, Bonekamp S, Clark JM,Wang NY, et al. Effect of exercise on blood
pressure in type 2 diabetes: a randomized controlled trial. J Gen Intern Med 2012;27:1453–9.
Ko GT, Li JK, Kan EC, LoMK. Effects of a structured health education programme by a diabetic education
nurse on cardiovascular risk factors in Chinese type 2 diabetic patients: a 1-year prospective
randomized study. Diabet Med 2004;21:1274–9.
Kirk A, Mutrie N, MacIntyre P, Fisher M. Effects of a 12-month physical activity counselling
intervention on glycaemic control and on the status of cardiovascular risk factors in people with type 2
diabetes. Diabetologia 2004;47:821–32.
Krein SL, Klamerus ML, Vijan S, Lee JL, Fitzgerald JT, Pawlow A, et al. Case management for patients
with poorly controlled diabetes: a randomized trial. Am J Med 2004;116:732–9.
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Search Strategies
Refer to the existing systematic review for information about the search strategy:
Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2
diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016;27;37- 47.
Review References
Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2
diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016;27;37-47.
Considerations for Implementation
Look ARG, Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk
factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch
Intern Med 2010;170:1566–75.
Mohamed H, Al-Lenjawi B, Amuna P, Zotor F, Elmahdi H. Culturally sensitive patient-centred
educational programme for self-management of type 2 diabetes: a randomized controlled trial. Prim
Care Diabetes 2013;7:199–206.
Salinero-Fort MA, Carrillo-de Santa Pau E, Arrieta-Blanco FJ, Abanades-Herranz JC, Martin-Madrazo
C, Rodes-Soldevila B, et al. Effectiveness of PRECEDE model for health education on changes and level
of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes
mellitus. BMC Public Health 2011;11:267.
Sevick MA, Korytkowski M, Stone RA, Piraino B, Ren D, Sereika S, et al. Biophysiologic outcomes of the
Enhancing Adherence in Type 2 Diabetes (ENHANCE) trial. J Acad Nutr Diet 2012;112:1147–57.
Sone H, Tanaka S, Iimuro S, Tanaka S, Oida K, Yamasaki Y, et al. Long-term lifestyle intervention
lowers the incidence of stroke in Japanese patients with type 2 diabetes: a nationwide multicentre
randomised controlled trial (the Japan Diabetes Complications Study). Diabetologia 2010;53:419–28.
Trento M, Passera P, Bajardi M, Tomalino M, Grassi G, Borgo E, et al. Lifestyle intervention by group
care prevents deterioration of type II diabetes: a 4-year randomized controlled clinical trial.
Diabetologia 2002;45:1231–9.
Uusitupa M, Laitinen J, Siitonen O, Vanninen E, Pyorala K. The maintenance of improved metabolic
control after intensified diet therapy in recent type 2 diabetes. Diabetes Res Clin Pract 1993;19:227–38.
Wisse W, Boer Rookhuizen M, de Kruif MD, van Rossum J, Jordans I, ten Cate H, et al. Prescription of
physical activity is not sufficient to change sedentary behavior and improve glycemic control in type 2
diabetes patients. Diabetes Res Clin Pract 2010;88:e10–3.
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Crosswalks
Healthy People 2030
Healthy People 2030 includes the following objectives related to this CPSTF recommendation.
The following considerations are drawn from studies included in the evidence review, the broader
literature, and expert opinion.
The U.S. Preventive Services Task Force (USPSTF) issued the following in 2015:
The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose as part of
cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese. Clinicians should
offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions to
promote a healthful diet and physical activity. (B recommendation: October 2015)
This recommendation will likely increase demand for early intervention to support patients in
making lifestyle changes and adopting long-term self-management behaviors.
Close coordination between healthcare systems, healthcare providers, and community-based
programs will likely be an essential element of sustainable community-based services.
Healthcare coverage for preventive services recommended by the USPSTF will likely be an
important source of funding for community-based programs once barriers to billing and
reimbursement are addressed.
Patients with, or at increased risk for, cardiovascular disease may need pre-intervention
assessments before initiating changes in physical activity, diet, and weight management.
Patients will need regular, ongoing diabetes care and medication management, which may
require adjustment as lifestyle changes are adopted.
Participants may be at increased risk for injuries associated with changes in physical
activity. This risk can be reduced if walking is emphasized as the primary mode of physical
activity with gradually increasing activity levels added as tolerated.
Reduce the proportion of adults with diabetes who have an A1c value above 9 percent — D‑03 (https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes/reduce-proportion-adults-
diabetes-who-have-a1c-value-above-9-percent-d-03)
Increase the proportion of people with diabetes who get formal diabetes education — D‑06 (https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes/increase-proportion-
people-diabetes-who-get-formal-diabetes-education-d-06)
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The Community Guide
Page last reviewed: September 03, 2020
Page last updated: December 22, 2021
Content Source: The Guide to Community Preventive Services
Disclaimer: The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task force evidence-based
recommendations are not mandating for compliance or spending. Instead, they provide
information and options for decision makers and stakeholders to consider when determining
which programs, services, and policies best meet the needs, preferences, available resources, and
constraints of their constituents.
Sample Citation: Guide to Community Preventive Services. Diabetes Management: Intensive Lifestyle Interventions
for Patients with Type 2 Diabetes. https://www.thecommunityguide.org/findings/diabetes-
intensive-lifestyle-interventions-patients-type-2-diabetes. Page last updated: December 22,
@CPSTF (https://twitter.com/cpstf)
(404) 498-1827
communityguide@cdc.gov
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Introduction
45-41 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned. |
Literature Support 91-84 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned. |
Methodology 58-53 points Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met. |
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Average Score 50-85% |
40-38 points More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided. |
83-76 points Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration. |
52-49 points Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met. |
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Poor Quality 0-45% |
37-1 points The background and/or significance are missing. No search history information is provided. |
75-1 points Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration. |
48-1 points There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met |
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Variations Between Specific Programs in Different Populations |
Variations Between Specific Programs in Different Populations